Adjustment of Pediatric Brain Tumor Survivors

描述（由申请人提供）：颅内肿瘤是第二种最常见的儿科癌症。与接受其他类型恶性肿瘤治疗的儿童相比，这些肿瘤的位置以及标准治疗对脑完整性造成的风险可能会增加脑肿瘤（BT）幸存者的心理社会发病率。许多研究已经记录了接受BT治疗的儿童的认知缺陷，但较少关注他们的社会，情感，行为和家庭功能。现有数据表明，儿童BT的幸存者有长期社交和情感困难的风险。照顾BT幸存者也可能影响父母的痛苦和家庭功能。然而，没有任何工作确定导致这些儿童和家庭长期困难的具体途径。在经验性干预开始之前，有关可能介导儿科BT影响的过程的信息是必不可少的。儿童困难的潜在媒介可能包括社会技能，非社会属性（例如，身体外观、运动能力）、同伴关系和健康状况。调解人，保证探索父母的痛苦，包括儿童的健康状况和照顾者的负担。拟议的研究将评估完成BT治疗的学龄（8-15岁）儿童。对于每个孩子，将招募一名相同种族，性别和年龄的同学作为比较（COMP）。将从教室（教师，同伴，自我报告）和家庭（母亲，父亲和儿童报告）的多个来源获得所有参与者的相同数据，以测试社会，情感，行为和父母/家庭功能的组差异。分析将检查组的差异，以及开始，以确定可能调解结果的差异的机制。这项工作将为更大规模的研究提供初步数据和方向，这些研究可以为临床试验的设计做出重大贡献，以预防或改善BT幸存者的长期心理社会发病率。和行为功能的儿童接受治疗的BT和人口统计学上类似的COMP。具体目标2比较父母和家庭功能的儿童治疗具体目标3探索可能在接受BT治疗的儿童及其家庭中调解适应困难发生的过程。具体目标4开始识别调节因子，其基于背景特征（例如，年龄、性别）和疾病因素（例如，肿瘤类型或治疗）。

DESCRIPTION (provided by applicant): Intracranial tumors are the second most common form of pediatric cancer. The location of these tumors, and the risk to cerebral integrity posed by standard treatments, may increase psychosocial morbidity for brain tumor (BT) survivors compared to children treated for other types of malignancies. Numerous studies have documented cognitive deficits for children treated for BT, but less attention has focused on their social, emotional, behavioral, and family functioning. Existing data suggests that survivors of pediatric BT are at risk for longstanding social and emotional difficulties. Caring for BT survivors also may affect parental distress and family functioning. However, no work has identified specific pathways that lead to long-term difficulties for these children and families. Information about the processes that might mediate the impact of pediatric BT is essential before empirically derived interventions can begin. Potential mediators for difficulties in children might include social skills, nonsocial attributes (e.g., physical appearance, athletic ability), peer relationships, and health status. Mediators that warrant exploration for parental distress include the child's health status and caregiver burden. The proposed research will evaluate school aged (8-15 years) children who have completed treatment for BT. For each child, a classmate of the same race, gender, and age will be recruited as a comparison (COMP). Identical data will be obtained for all participants from multiple sources in classrooms (teacher, peer, self-report) and homes (mother, father, and child-report) to allow tests of group differences in social, emotional, behavioral, and parent/family functioning. Analyses will examine group differences as well as begin to identify mechanisms that may mediate differences in outcomes. This work will provide preliminary data and direction for larger scale studies that can make a significant contribution to the design of clinical trials to prevent or ameliorate long-term psychosocial morbidity in BT survivors.Specific Aim 1 Compare the social, emotional, and behavioral functioning of children who have received treatment for BT and demographically similar COMP.Specific Aim 2 Compare parent and family functioning for children treated for BT and COMP.Specific Aim 3 Explore processes that might mediate the occurrence of difficulties in adjustment among children treated for BT and their families.Specific Aim 4 Begin to identify moderators that categorize subgroups at higher risk for difficulties based on background characteristics (e.g., age, gender) and disease factors (e.g., type of tumor or treatment).