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PEDIATRICS Vol. 103 No. 1 January 1999, pp. 71-78

Social, Emotional, and Behavioral Functioning of Children With Cancer

Received May 18, 1998; accepted Aug 24, 1998.

Robert B. Noll*, Maria A. Gartstein*, Kathryn Vannatta*, Judy Correll*, William M. BukowskiDagger , and W. Hobart Davies§

From the * Children's Hospital Medical Center, Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio; the Dagger  Department of Psychology, Concordia University, Montreal, Canada; and the § Department of Psychiatry, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.

Objective.  It was hypothesized that children with cancer would have more social problems and difficulties with emotional well-being than case control, same race/gender, similarly aged classmates.

Study Design.  Using a case controlled design, children with any type of cancer requiring chemotherapy except brain tumors (n = 76), currently receiving chemotherapy, ages 8 to 15, were compared with case control classroom peers (n = 76). Peer relationships, emotional well-being, and behavior were evaluated based on peer, teacher, parent, and self-report, and were compared using analysis of variance and structural equation modeling.

Results.  Relative to case controls, children with cancer were perceived by teachers as being more sociable; by teachers and peers as being less aggressive; and by peers as having greater social acceptance. Measures of depression, anxiety, loneliness, and self-concept showed no significant differences, except children with cancer reported significantly lower satisfaction with current athletic competence. There were also no significant differences in mother or father perceptions of behavioral problems, emotional well-being, or social functioning. Scores on all standardized measures were in the normal range for both groups. Comparisons of the correlation matrices of children with cancer and to the correlation matrix of the comparison children using structural equation modeling suggested they were not significantly different.

Conclusions.  Children with cancer currently receiving chemotherapy were remarkably similar to case controls on measures of emotional well-being and better on several dimensions of social functioning. These findings are not supportive of disability/stress models of childhood chronic illness and suggest considerable psychologic hardiness.  Key words:  childhood cancer, psychosocial morbidity.




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