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Journal of Pediatric Psychology Advance Access published online on October 1, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp084
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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

Optimism and Pessimism in Children with Cancer and Healthy Children: Confirmatory Factor Analysis of the Youth Life Orientation Test and Relations with Health-Related Quality of Life

Natalie A Williams, PhD1, Genevieve Davis, MS1,2, Miriam Hancock, PhD1 and Sean Phipps, PhD1

1Department of Behavioral Medicine, St Jude Children's Research Hospital and 2University of Memphis

All correspondence concerning this article should be addressed to Sean Phipps, PhD, Department of Behavioral Medicine, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-2794, USA. E-mail: sean.phipps{at}stjude.org


  Abstract

Objective To test the measurement equivalence of the Youth Life Orientation Test (YLOT) in children with cancer (N = 199) and healthy controls (N = 108), and to examine optimism and pessimism as predictors of children's health-related quality of life (HRQL). Methods Confirmatory factor analysis (CFA) was conducted to establish the two factor structure of the YLOT and to test for metric invariance. Results A two-factor structure for the YLOT was confirmed and found to be stable across our study groups. There were no differences in mean levels of optimism and pessimism between cancer patients and controls after controlling for race/ethnicity. Higher optimism was associated with lower self-reports of pain and better emotional/behavioral functioning, whereas pessimism was related to poorer mental health and general behavior, and greater impact on the family. Conclusions Optimism and pessimism appear to be differentially related to certain aspects of children's HRQL, and should be investigated separately in relation to these outcomes.

Key words: childhood cancer; HRQL; optimism; pessimism..

Received January 27, 2009; revision received August 14, 2009; accepted August 23, 2009


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