Poster #190 - Social Problem Solving Deficits in Pediatric Brain Tumor Survivors: Linkages to Social Withdrawal and Victimization

• In Event: 3-159 - Poster Session 12
  In Poster Session: PS 12 Section - Social Cognition

Integrative Statement

Purpose: Survival rates for children with brain tumors have steadily improved, but these children face a myriad of developmental challenges. Social isolation and peer victimization are consistently reported, heightening interest in skill deficits that may contribute to these difficulties and be amenable to intervention (Hocking et al., 2015). Cognitive late-effects involving deficits in attention and executive functioning may undermine social problem solving (SPS) for pediatric brain tumor survivors (PBTS). Unfortunately, there is little data about specific SPS deficits in PBTS and whether SPS deficits are evident across social contexts. We hypothesized that 1) PBTS would exhibit deficits in cue encoding compared to control classmates (CC), 2) PBTS would generate fewer competent and more ineffective strategies than CC, and 3) these SPS variables would be correlated with Shy/Withdrawn behavior and peer Rejection/Victimization. Exploratory analyses of group differences in attribution biases and evaluations of strategies to achieve affiliative and instrumental goals in both peer-group entry and provocation situations were performed.
Methods: PBTS (N=109, 57.8% male), ages 8-16 (Mage=11.8, SD=2.0) at least one-year post-treatment, were recruited from three hospitals in the USA and Canada. CC matched for gender and age (N=61, 60.7% male, Mage=12.4, SD=2.0) were recruited from classrooms of PBTS. Groups did not differ on maternal education or family income. PBTS and classmates with consent (86%) completed the Extended Class Play, evaluating Shy/Withdrawn behavior and Rejection/Victimization. PBTS and CC also completed the Social Information Processing Interview which presents peer-group entry and provocation video-vignettes and evaluates cue Encoding, intent Attributions, Response Generation, and Evaluations of competent, aggressive, and ineffective strategies. Independent t-tests evaluated group differences in SPS. Correlations evaluated associations between SPS and Shy/Withdrawn behavior and Rejection/Victimization.
Results: As hypothesized, PBTS encoded fewer relevant cues and suggested fewer competent strategies for peer-group entry, but this was not found in response to peer provocation (Table 1). Differences were also found on exploratory tests of Response Evaluation variables, reflecting more positive evaluations of ineffective and aggressive strategies by PBTS, as well as less positive evaluations of competent strategies. Data from the Extended Class Play indicated higher levels of Shy/Withdrawn behavior (MPBTS=0.44, SD=1.11; MCC=-0.08, SD=0.84; t(143)=-3.05, p=.003) and Rejection/Victimization (MPBTS=0.43, SD=1.01; MCC=-0.18, SD=0.88; t(143)=-3.74, p=.002) for PBTS. Shy/Withdrawn behavior and Rejection/Victimization were significantly correlated with multiple components of SPS, especially the Response Evaluation variables, for peer-group entry situations (Table 2). Evaluation of responses to achieve instrumental goals in response to provocation were also correlated with Shy/Withdrawn behavior.
Conclusion: This study replicates findings that PBTS demonstrate heightened levels of social isolation and victimization by peers. Our results suggest that PBTS may demonstrate SPS deficits linked to these peer relationship difficulties. PBTS appear to miss relevant cues, generate more ineffective response strategies, and undervalue competent responses to social challenges. Interestingly, these SPS deficits are more pronounced in situations that involve initiation of peer interaction than responding to provocations by peers. These findings could inform efforts to develop interventions tailored to PBTS. Research toward that goal should consider other neurocognitive and social-affective abilities which may be impaired for PBTS.

Authors

• Elizabeth Melfi, Nationwide Children's Hospital
  Presenting Author

• Jennifer Kelleher, Nationwide Children's Hospital
  Non-Presenting Author

• Maru Barrera, Hospital for Sick Children
  Non-Presenting Author

• Andrea F Patenaude, Dana Farber Cancer Institute
  Non-Presenting Author

• Ute Bartels, Hospital for Sick Kids
  Non-Presenting Author

• Randal Olshefski, Nationwide Children's Hospital and The Ohio State University
  Non-Presenting Author

• Cynthia Gerhardt, The Research Institute at Nationwide Children's Hospital
  Non-Presenting Author

• Kathryn Vannatta, The Research Institute at Nationwide Children's Hospital and the Ohio State University
  Non-Presenting Author