Predicting deficits in social competence for pediatric brain tumor survivors

描述(申请人提供)：尽管NCI的使命是减轻幸存者的癌症负担，但在减少儿童脑瘤幸存者(PBTS)的心理社会发病率方面进展甚微。社会缺陷，以及医学和神经认知障碍，都威胁着他们的短期和长期生活质量。在我们的研究中，同学们将PBTS描述为社交孤僻、受害和被同龄人排斥、不那么受欢迎，朋友也比对照同学少。接受辐射治疗的女孩和儿童的结果最差，但社会损害并不局限于他们。这些困难，特别是同龄人报告的，强烈预示着以后生活中的情感、行为和学习困难，而PBTS在成年后表现出比任何其他儿科癌症幸存者亚群更多的这些缺陷。不幸的是，我们缺乏得到证实的干预措施来帮助这些儿童。研究尚未确定具体的、可传授的技能，当技能不足时，这些技能可以解释PTB患者不良的社会结果。社会生态因素可能会影响PTB的社会结果，并可能成为干预的目标，但尚未对这一人群进行检查。因此，我们的长期目标是通过为PBTS制定量身定制的干预措施来降低发病率。这项建议的目标是确定社会信息的性质和范围 处理缺陷，并确定它们是否与社会生态因素一起造成社会困难的风险。我们将招募212名PBT(8-13岁，治疗后1年) 3家儿科医院。在学校和家庭中，将使用混合方法(即问卷、基于表现的测量和模拟测量、与朋友的录像互动)和多种报告来源(同伴、教师、母亲、父亲、孩子)来评估社交能力(即社交信息处理技能、社交行为和互动、社会适应)和背景资源(即亲子关系和养育行为、友谊质量和学校环境)。每个PBTS的一个对照同学将获得相同的数据，并与性别、种族和年龄匹配。理由是，确定这些因素将允许通过了解以下情况来选择和设计有效的干预措施 针对哪个PBTS的目标是什么。我们的中心假设是，社会信息处理技能将解释PBTS在社会行为和适应方面的差异，家庭、友谊和学校的资源将缓冲肿瘤和治疗对社会能力的影响。拟议的研究具有重要意义，因为它将使我们能够开发有效的服务，将PTB的长期发病率降至最低。

DESCRIPTION (provided by applicant): Despite the NCI's mission to reduce the burden of cancer on survivors, little progress has been made toward reducing psychosocial morbidity for pediatric brain tumor survivors (PBTS). Social deficits, as well as medical and neuro-cognitive impairment, threaten both their short and long-term quality of life. In our research, classmates have described PBTS as socially withdrawn, victimized and excluded by peers, less liked, and having fewer friends than control classmates. Girls and children treated with radiation have the worst outcomes, but social impairment is not limited to them. These difficulties, particularly as reported by peers, are strongly predictive of emotional, behavioral, and academic difficulties later in life, and PBTS demonstrate more of these deficits as adults than any other subgroup of pediatric cancer survivors. Unfortunately, we lack proven interventions to help these children. Research has yet to identify specific, teachable skills that, when deficient, account for poor social outcomes among PTBS. Social-ecological factors may moderate social outcomes for PTBS and could be targeted by interventions, but have not been examined for this population. Thus, our long- term goal is to reduce morbidity for PBTS by developing tailored interventions for them. The objective of this proposal is to identify the nature and extent of social information processing deficits in PBTS and determine if they, along with social-ecological factors, account for risk for social difficulties. We will recruit 212 PBTS (ages 8-13, >1 year post-treatment) from 3 pediatric hospitals. Mixed methods (i.e., questionnaires, performance- based and analog measures, video-taped interactions with friends) and multiple reporting sources (peer, teacher, mother, father, child) will be used in schools and homes to assess social competence (i.e., social information processing skills, social behavior and interactions, social adjustment) and contextual resources (i.e. parent-child relationship and parenting behavior, friendship quality, and school environment) that account for social competence. Identical data will be obtained for one control classmate per PBTS, matched for gender, race, and age. The rationale is that identifying these factors will allow the selection and design of effective interventions by knowing what to target for which PBTS. Our central hypothesis is that social information processing skills will account for differences in social behavior and adjustment for PBTS, and resources in their families, friendships, and schools will buffer the impact of the tumor and treatment on social competence. The proposed research is significant because it will enable us to develop effective services to minimize long-term morbidity in PTBS.