Emotional and behavioral late effects in pediatric oncology survivors

dc.contributor.advisorRobillard, Rachel Westen
dc.contributor.advisorStark, Kevin Douglasen
dc.contributor.committeeMemberTharinger, Deborahen
dc.contributor.committeeMemberMercer, Walten
dc.contributor.committeeMemberBorich, Garyen
dc.creatorGarcia, Michael Isaacen
dc.date.submittedDecember 2010en
dc.description.abstractThe most common form of childhood cancer is Acute Lymphoblastic Leukemia (ALL). Patients treated for ALL may experience short- and long-term physiological and cognitive effects due to treatment. However, delayed emotional and behavioral effects in pediatric survivors, as well as risk-factors that may make them more susceptible to developing problems with psychological and behavioral functioning are less understood. Studies investigating pediatric survivors have demonstrated that negative emotional and behavioral late effects can and do occur (Hobbie et al., 2000; Buizer et al. 2006; Novakovic et al., 1996; Mulhern, Wasserman, Friedman, & Fairclough, 1989), and it has been purported that survivors experience higher rates of depression, anxiety and low self-esteem (Koocher, O’Malley, Gogan, & Foster, 1980; Kazak, 1994). Anxiety in particular, has been identified as one of the longest lasting psychological sequelae of cancer (Kazak, 1994). Still, the data on long-term psychological sequelae is mixed, with some studies suggesting healthy, long-term, psychological adjustment (Brown et al., 1992; Fritz, Williams & Amylon, 1988; Greenberg, Kazak, & Meadows, 1989). This pilot study attempted to investigate emotional and behavioral late effects of cancer as reported by survivors and their caregivers on the Behavior Assessment System for Children, Second Edition (BASC-2). This study also investigated potential risk factors that made it more likely to develop emotional and behavioral late-effects. This study hypothesized that females, those undergoing high intensity chemotherapy, and those starting chemotherapy at an earlier age, would report significantly more internalizing and externalizing problems. Analysis revealed significant differences in reporting of anxiety, depression, attention and hyperactivity symptoms combined based on the age when treatment started. No other significant findings were uncovered; however, in an effort to provide directions for future research, patterns in the data were examined by comparing overall means on BASC-2 subscales. For example, females reported more hyperactive symptoms than males. In general, individuals who started treatment at younger ages reported more difficulty with emotional and behavioral functioning. Additionally, males and females adaptive behavior fell within normal limits. Overall, no BASC-2 mean scores were in the at-risk or clinically significant range of impairment suggesting adequate emotional, behavioral and adaptive functioning overall.en
dc.description.departmentEducational Psychologyen
dc.subjectLate effectsen
dc.subjectLeukemia in childrenen
dc.subjectCancer in childrenen
dc.subjectCancer treatmenten
dc.subjectPediatric canceren
dc.subjectPediatric oncologyen
dc.subjectDepression in cancer patientsen
dc.subjectChildren survivors of canceren
dc.titleEmotional and behavioral late effects in pediatric oncology survivorsen
thesis.degree.departmentEducational Psychologyen
thesis.degree.disciplineEducational Psychologyen
thesis.degree.grantorUniversity of Texas at Austinen
thesis.degree.nameDoctor of Philosophyen

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