Poster #36 - Moderating Effects of Parenting on the Relation Between Stress and Child Psychopathology During Cancer Treatment

• In Event: Poster Session 16

Abstract

Background:
The first year of pediatric cancer treatment is highly stressful for families, contributing to poorer adjustment in some children (Sharp et al., 2022). It is therefore important to understand how parenting can affect the relation between stressors during treatment and children’s psychopathology. Previous studies indicate that parenting behaviors such as hostility and overprotection are associated with poorer psychological outcomes in children with cancer, whereas positive parental involvement is protective (Cline et al., 2006; Hullman et al., 2010; Tillery et al., 2019). We hypothesized that caregiver warmth and respect for child autonomy as well as acceptance and coaching of children’s emotions would buffer the negative impact of cumulative stress on child psychopathology one year post-diagnosis, whereas negative parenting behaviors (negative affect, negative control) would aggravate the association between stress and child psychopathology.

Methods:
Primary caregivers of children aged 2 to 18 recently diagnosed with cancer (n=159) completed monthly questionnaires for one year. Cumulative stress at month 1 was examined by taking the weighted average of negative life events, financial strain, treatment-related stressors, perceived life threat, and treatment intensity reported by primary caregivers. At month 3, the Parent Meta-Emotion Interview was used to assess acceptance and coaching of children’s emotions. Primary caregivers were also observed in a 12-minute interaction task with their children, and the Family-Level Interaction Coding System was used to measure parental warmth (mean of positive affect and interactiveness), negative parenting (mean of negative affect and negative control), and respect for autonomy. At month 12, primary caregivers reported on their children’s internalizing, externalizing, and post-traumatic stress symptoms. Fifteen moderation models were tested when examining parenting behaviors and parent approaches to their children’s emotions as moderators of the association between month 1 cumulative stress and month 12 child psychopathology, with child age and gender as covariates.

Results:
Cumulative stress predicted externalizing symptoms only among children of caregivers rated low in respect for autonomy (b=49.88, t(36)=2.76, p<0.01). Cumulative stress positively predicted depression/anxiety symptoms among children of caregivers who were high in acceptance of their children’s emotions (b=25.72, t(51)=2.17, p=0.03). Parental warmth, negative parenting, and emotion coaching did not moderate the association between cumulative stress and child psychopathology.

Conclusion:
During a time when caregivers may feel heightened protectiveness for their children, lower respect for child autonomy may exacerbate the link between stressors and child externalizing in the first year after a pediatric cancer diagnosis. To support the well-being of children with cancer, caregivers could benefit from interventions that help them to support their child’s autonomy during treatment. Unexpectedly, greater caregiver acceptance of their children’s emotions was also linked to a stronger association between stressors and future child depression/anxiety. Caregivers who are more accepting of their children’s emotions may be better equipped to recognize internalizing symptoms, and their children may be more comfortable expressing negative feelings. Future research should examine the long-term impact of caregiver responses to children’s emotions when managing stressors.

Authors

• Joohee Lee, University of Washington
  Presenting Author

• Samantha Seaver

• Mary Huynh, University of Washington

• Sameen Boparai, University of Washington

• Debra L. Friedman, Vanderbilt University Medical Center

• Bruce Edward Compas, Vanderbilt University

• Lynn Fainsilber Katz, University Of Washington