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Journal of Pediatric Psychology Advance Access originally published online on April 2, 2007
Journal of Pediatric Psychology 2007 32(7):771-782; doi:10.1093/jpepsy/jsm013
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Trajectories of Adjustment in Mothers of Children with Newly Diagnosed Cancer: A Natural History Investigation

Michael J. Dolgin, PhD1, Sean Phipps, PhD2, Diane L. Fairclough, DrPH3, Olle Jane Z. Sahler, MD4, Martha Askins, PhD5, Robert B. Noll, PhD6, Robert W. Butler, PhD7, James W. Varni, PhD8 and Ernest R. Katz, PhD9

1Schneider Children's Medical Center, Israel, 2St. Jude Children's Research Hospital, 3University of Colorado Health Sciences Center, 4University of Rochester Medical Center, 5M.D. Anderson Cancer Center, 6Children's Hospital of Pittsburgh, 7Oregon Health and Science University, 8Texas A&M University, and 9Children's Hospital of Los Angeles

All correspondence concerning this article should be addressed to Michael J. Dolgin PhD, 29 Ha'atzmaut Street, Ra'anana 43461, Israel. E-mail: mdolgin{at}netvision.net.il.


  Abstract

Objectives The objectives of this study were (a) to assess negative affectivity and posttraumatic symptomatology in mothers following the diagnosis of cancer in their children; (b) to examine sociodemographic and psychosocial variables associated with change in distress over time; and (c) to identify distinct subgroups of mothers whose patterns and trajectories of adjustment can be distinguished according to available predictor data. Methods Two hundred and twelve mothers at seven sites were assessed just following their child's diagnosis, and again 3 months and 6 months later. Primary outcomes included measures of mood disturbance, depressive symptoms, and symptoms of posttraumatic stress. Results Overall, mothers demonstrated a pattern of mildly elevated negative affectivity and posttraumatic symptomatology initially, with steady improvements evident at 3- and 6-month follow-up. Distinct adjustment trajectories were evident within the sample as a whole, indicating subgroups of mothers with high-declining, moderate-stable, and low-stable distress levels. Conclusions These findings highlight considerable resilience among mothers facing the stress of childhood cancer. Intervention efforts aimed at reducing maternal distress might best be targeted towards the subgroup of mothers who may be predicted to exhibit the highest level of distress.

Key words: childhood cancer; mothers; psychosocial adjustment.

Received May 16, 2006; revision received February 2, 2007; accepted February 5, 2007


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