Impact of victimization on depressive symptoms for children surviving brain tumors: Moderation by social support

• In Event: Poster Session 09
  In Poster Session: PS 09 Topic - Developmental Psychopathology

Abstract

Purpose: Brain tumors are the second most common form of pediatric cancer and, with aggressive treatment, 70% of affected children now survive more than 5 years post-diagnosis. Unfortunately, survival comes at a cost. Pediatric brain tumor survivors (PBTS) are consistently reported to have fewer friends and experience more social isolation and victimization by peers than healthy classmates or children with other forms of cancer (Hocking et al., 2015). Despite links between victimization and depression for children in general (Barchia & Bussey, 2010), affective difficulties are inconsistently reported for PBTS (Bell et al., 2018). Resources need to be identified that may promote resilience for PBTS confronted by victimization, e.g. friendship (Bukowski et al., 2010) or parental support (Stice et al., 2004). Our objectives were to test 1) whether differences in depressive symptoms for PBTS and healthy comparison classmates (CC) are mediated by rejection and victimization experienced at school and 2) if different sources of social support moderate that indirect effect (Figure 1). Method: PBTS, ages 8-14 and at least one year post-treatment for a primary brain tumor, were recruited at three oncology centers in the US and Canada. Rejection-Victimization was assessed using the Extended Class Play (Bowker et al., 2006) completed by classmates (86% available with consent) in a primary classroom for each PBTS. Subsequently, families of PBTS (N=90; 46.7% female, 74.4% white and non-Hispanic) and CC (N=66; 39.3% female, 72.1% white and non-Hispanic) completed 1:1 assessments including the Children’s Depression Inventory II (CDI; Kovacs, 1992) and the Social Support Scale for Children (SSSC; Harter, 1999. The SSSC evaluates perceived support from friends, parents, teachers, and peers. Analyses tested indirect effects using multiple regression and post-hoc bootstrapping (10,000 samples, 95% confidence interval) of overall and contingent indirect effects using the PROCESS 3.4 module for SPSS (Hayes, 2019). Results: Higher levels of Rejection-Victimization were found for PBTS than CC (d = 0.63, p = .000), but no significant group (PBTS vs CC) differences were found for depressive symptoms or levels of social support from friends, parents, teachers, or peers. The indirect effect of group on depressive symptoms via Rejection-Victimization was not significant overall. However, this indirect effect was significant contingent upon levels of perceived support from friends, parents, and teachers (Table 1), achieving significance when support from teachers, parents, or friends was low but not significant when support was high. General peer support did not moderate the indirect effect. Discussion: Overall, results suggest that multiple sources of social support may attenuate links between peer victimization and depressive symptoms and offer protection from distress for PBTS experiencing exclusion and victimization by peers. The relevance of teacher support, in addition to support from parents and friends, was unexpected and worth noting. Although PBTS may not, overall, be at risk for elevations in depressive symptoms, children experiencing victimization and lacking support from a friend or caring adults may be at risk.

Authors

• Payton L Hummer, Nationwide Children's Hospital
  Presenting Author

• Noelle C. Marousis, Miami University - Ohio
  Non-Presenting Author

• Brian Delaney, Dana Farber Cancer Institute
  Non-Presenting Author

• Keith O Yeates, University of Calgary
  Non-Presenting Author

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

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

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

• Kathryn Vannatta, Ohio State University & The Research Institute at Nationwide Children’s Hospital
  Non-Presenting Author