Coping, Communication, and Adjustment in Pediatric Cancer: The Role of Children's Executive Function
Rodriguez, Erin M
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2011-06-30
Abstract
Previous research with children with cancer has suggested links between adjustment and parent-child communication, coping, and executive function, but little research has addressed how communication, coping, and executive function may be interrelated within the context of adjustment. The current studies examined the relationships between these constructs in children with cancer and their parents, for whom communication, coping, and executive function may be especially relevant, given the stressful nature of pediatric cancer and the effects of medical treatment on children’s executive functioning. Study 1 examined communication at macro- and micro-levels of analysis, in order to understand how mothers’ linguistic complexity and contingent responses to their children were related to mothers’ and children’s global patterns of emotions and behaviors during a mother-child interaction about cancer. The findings indicate that certain maternal contingent responses (e.g., reflections, expansions) are characteristic of positive behaviors and emotions (e.g., positive mood, listener responsiveness), while other maternal contingent responses (e.g., reframes, imperatives) are characteristic of negative behaviors and emotions (e.g., hostility, neglect/distancing) in both mothers and children. In study 2, children’s executive function was examined in relation to children’s primary and secondary control coping, parents’ linguistic complexity, and children’s anxiety/depression, internalizing problems, and externalizing problems. The results suggest that better executive function is related to higher levels of secondary control coping and fewer adjustment problems in children, with coping accounting for the relationship between executive function and adjustment. Further, the results indicate that higher parental linguistic complexity is related to poorer executive functioning in children, and that parents who “undershoot” their children’s level of executive functioning by using less complex language have children who use more secondary control coping and have fewer adjustment problems. The findings of both studies suggest implications for parenting and communication interventions for pediatric cancer populations, such as teaching parents to use reflections and simple language when talking with their children about cancer.