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Journal of Pediatric Psychology Advance Access published online on March 26, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp019
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© The Author 2009. 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

Survivors of Childhood Cancer and Comparison Peers: The Influence of Peer Factors on Later Externalizing Behavior in Emerging Adulthood*

Amanda L. Thompson, PhD1, Cynthia A. Gerhardt, PhD1, Kimberly S. Miller, MA1, Kathryn Vannatta, PhD1 and Robert B. Noll, PhD2

1Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and The Ohio State University, 2Child Development Unit, Children's Hospital of Pittsburgh

*Portions of this article were presented at the 4th Biennial Cancer Survivorship Research Conference, Atlanta, GA, June 2008 and the Society for Developmental and Behavioral Pediatrics 2008 Annual Meeting, Cincinnati, OH, October 2008. All correspondence concerning this article should be addressed to Cynthia A. Gerhardt, PhD, The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health, Rm. JW4992, 700 Children's Drive, Columbus, OH 43205-2696, USA. E-mail: cynthia.gerhardt{at}nationwidechildrens.org.


  Abstract

Objective To examine group differences and predictors of externalizing behavior and substance use during the transition to emerging adulthood (i.e., ages 18–25) among survivors of childhood cancer and comparison peers. Methods Peer acceptance and social behavior were assessed in classrooms of 55 children (ages 8–15) during cancer treatment. Children with cancer, comparison peers (n = 60), and parents completed measures of externalizing behavior and/or substance use during an initial home visit and soon after participants turned 18.  Results At follow-up, survivors and peers exhibited similar externalizing behaviors and substance use, except peers were more likely to use marijuana. Substance use was associated with earlier peer acceptance and social behavior. Survivors who were older at diagnosis were at greater risk for later externalizing behavior and substance use. Conclusions Mean externalizing behaviors and substance use generally fell within normative ranges for both survivors and peers. Some survivors may benefit from interventions to reduce risk behavior.

Key words: cancer; externalizing behavior; peer relationships; substance use..

Received September 5, 2008; revision received February 26, 2009; accepted February 26, 2009


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