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Poster #114 - Peer Relationships, Parenting, and Self-Worth in Pediatric Brain Tumor Survivors and Healthy Controls

Sat, March 25, 11:30am to 12:15pm, Salt Palace Convention Center, Floor: 1, Hall A-B

Abstract

Background: Pediatric brain tumor survivors (PBTS) experience more social challenges, including peer victimization and social isolation than healthy peers (Vannatta et al., 2015). Although victimization (van Geel et al., 2018) and social withdrawal (Rubin et al., 1995) can have long-lasting adverse impacts on child and adolescent self-perceptions, the self-worth of PBTS has been understudied. Relatedly, supportive parenting can mitigate the negative effects of peer victimization (Healy & Sanders, 2018) and foster positive self-perception (Wouters et al., 2013), yet no studies to our knowledge have examined whether parenting behavior may buffer PBTS’ experiences of negative peer relationships. Due to these risks and an array of other psychosocial and neurocognitive sequelae (Rey-Casserly & Diver, 2019), PBTS need tailored interventions to support their adjustment. We hypothesized that PBTS would have more negative peer interactions than comparison classmates (CC), which would subsequently be related to lower self-worth. In addition, we hypothesized that parental warmth would moderate either the association of survivorship with negative peer interactions (Figure 1A) or the association of negative peer experiences with self-worth (Figure 1B). Methods: PBTS off-treatment for more than one year (n=83; Mage= 11.55(1.96); 60% male; 72% White/non-Hispanic) were identified from cancer registries at three institutions in the United States and Canada. Data were collected in schools, and CC (n=55; Mage= 11.91(2.00); 62% male; 71% White/non-Hispanic) were matched by age and gender to PBTS (Table 1). Classmates completed the Extended Class Play (Wojslawowicz-Bowker et al., 2006), yielding Shy/Withdrawn and Rejection/Victimization subscales to assess negative peer relationships. At subsequent home visits, PBTS and CC completed the Self-Perception Profile for Children (Harter, 1982) to assess Global Self-Worth, and the Children’s Report of Parent Behavior Inventory (Schaefer, 1965) to describe their mother’s and father’s parenting behaviors (i.e., Warmth, Behavioral Control, Psychological Control). Conditional process analyses were conducted using ordinary least squares regression (PROCESS; Hayes, 2012), using 10,000 bootstrap samples and controlling for child sex. Results: Indirect effects were not statistically significant, and parenting did not moderate the relationship between group and peer interaction variables (Figure 1A). However, parental Warmth did moderate the association between Shy/Withdrawn behavior and child Self-Worth (Figures 2A/B), resulting in contingent indirect effects of group on Self-Worth (Figure 1B). This indirect effect, whereby withdrawn behavior accounted for diminished self-worth in PBTS, was only significant when parents demonstrated high levels of Warmth. Rejection/Victimization was not associated with child Self-Worth, and parenting did not moderate this relationship. Conclusions: Limited evidence indicated that parental warmth and support, but not use of behavioral or psychological control, moderates perceived self-worth of PBTS who are not perceived as shy and withdrawn. Null findings suggest that parenting may not be protective of peer rejection and victimization, or self-worth, for PBTS in late childhood and early adolescence. These findings will be discussed in relation to the strengths and weaknesses of the study design. Research should identify other resources to promote resilience in PBTS, and school-based interventions should be developed to foster supportive peer relationships.

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